The enduring stigma around addiction has long been a problem in our society. But Rachel Bannister writes of her disappointment that this is present even within healthcare services
Addiction is something that happens to other people, isn’t it? Not to professional, educated, middle class women like myself. Before my own struggles with addiction began, the stereotyped depictions from 1980s government awareness adverts of people who lacked the will and determination to “just say no” pretty much summed up addiction to me.
Small wonder then that as I approached middle age, I hadn’t once considered the possibility that drugs, whether illegal or on prescription, could be something that could become a problem for me. I never once imagined that I’d face emotional pain so strong, so unbearable, that a foul tasting yet addictive green liquid would gradually become a normal part of my everyday existence. Or that I would find myself compelled to take it so often and increasingly in such large amounts that on one occasion I would wake up in the resuscitation department at our local hospital.
The enduring judgments around addiction in our society have long been a problem. But I hadn’t expected the stigma and lack of understanding I faced to be present even within healthcare services.
From comments I received about having “to be careful with junkies like you,” to an inability or unwillingness to make eye contact, some of my experiences in healthcare services left me with a feeling of shame so strong it simply strengthened my resolve to hide what was clearly a situation of my own making. Instances like these only served to deepen the shame and secrecy I felt around my increasingly dangerous behaviour, and made me think that it was something I must deal with or endure alone.
During the early days of my addiction, it felt as if there was no one who attempted to validate my feelings of pain. None of the healthcare professionals that saw me showed me the empathy and compassion I so desperately needed. There was the unspoken expectation, I believe, that I must somehow have it in me to reign in my reliance on the medication. I had a home and a partner after all.
So what would have made a difference?
Like any human being with an addiction, I haven’t chosen to walk this dangerous path and don’t, as was once suggested to me, have “an addictive personality.” Addiction I believe is borne of great suffering. For me, the liquid temazepam was a desperate and ultimately destructive means to alleviate great internal pain and trauma. Pain relief for what I describe as feeling like a “hole in my soul.”
Early intervention, for me, would have been the space and time to develop a therapeutic relationship with a clinician. The all important “continuity of care” with a highly experienced and skilled individual with whom you can build a trusting relationship. Sadly, not only have addiction services faced brutal cuts, but additionally we are facing the stark reality that the number of training places available for psychiatrists wishing to specialise in addiction is at its lowest in 15 years.
Undoubtedly, I am one of the lucky ones. With loved ones around me able to advocate on my behalf, I was eventually referred to a specialist addiction service where skilled staff offered me the compassion, understanding, and treatment that ultimately saved my life.
Here I experienced the “gold standard” of addiction services. I was cared for by a specialist trained nurse who would always look me in the eye and validate my pain. He helped me understand that my addiction wasn’t “who I was” but merely “where I was” and that meant there was hope for the future.
He drove me to my first psychiatric appointment where I was face to face with a doctor whose non-judgmental attitude and calm exterior meant I no longer faced the indignity of stigma and shame. The words he spoke that day sum up succinctly what so many of us long to hear in our darkest days:
“You just need a hand to hold to see you through this.”
For those like me lucky enough to be referred and accepted for treatment by specialist addiction teams, there is then the problem of treating an individual’s underlying difficulties. I believe we desperately need a revolution in therapeutic options with a particular emphasis on trauma resolution. For me, it hasn’t been the traditional “talking therapies” or psychotherapy that have been key in preventing relapse, but rather lesser known interventions, including eye movement desensitization and reprocessing and Parks Inner Child therapy. I have found it necessary to heal old wounds, some of which date back to my childhood, and this is why the voice of lived experience is so important if we are to transform services.
Addiction can happen to any one of us. We need to discard damaging stereotypes and properly invest not only in specialist addiction nursing and psychiatry, but also in effective therapy that will heal the wounds that lead so many to turn to dysfunctional and ultimately dangerous coping mechanisms.
Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.